Urinary and anal incontinence after vacuum delivery.
ABSTRACT To evaluate urinary and fecal incontinence symptoms, and occult anal sphincter defects in women after vacuum and spontaneous vaginal delivery.
In a case-control study, 50 primiparous women delivered by vacuum extraction were compared to 50 women delivered spontaneously. Urinary and anal incontinence symptoms, pelvic floor muscle strength and sphincter defects on endoanal ultrasound were evaluated 6-24 weeks postpartum.
New anal incontinence symptoms after childbirth were found in 30% of the vacuum group compared to 34% of the controls, new urinary incontinence symptoms in 28 and 42%, respectively (not significant). After excluding Grade III perineal tear, sonographic sphincter defects were found in 11 (27.5%) after vacuum delivery compared to 4 (10%) after spontaneous delivery (P<0.05, chi(2)-test).
Anal and urinary incontinence symptoms are frequent after vaginal delivery. Vacuum delivery causes more sonographic sphincter defects but appears to cause no more harm to pelvic floor function than spontaneous vaginal delivery.
- BJOG An International Journal of Obstetrics & Gynaecology 08/2005; 101(4):363 - 364. · 3.76 Impact Factor
- British Journal of Obstetrics and Gynaecology 07/1997; 104(6):753-4.
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ABSTRACT: The relationships among epidural anesthesia, forceps use, parity, episiotomy, and laceration were studied in 9493 uncomplicated vertex deliveries of spontaneous onset and normal course. The use of epidural anesthesia was not associated with an increased incidence or severity of birth-canal trauma. Episiotomy was associated with a decreased rate of perineal laceration, but an overall increase in the rate of perineal trauma. The trauma that did occur with episiotomies was four times more likely to be major than that when no episiotomy was performed.Obstetrics and Gynecology 06/1991; 77(5):668-71. · 4.80 Impact Factor